Are e‐cigarette use and vaping associated with increased respiratory symptoms and poorer lung function in a population exposed to smoke from a coal mine fire?

Abstract Background and objective E‐cigarette use has become increasingly prevalent, but there is some evidence demonstrating potential harms with frequent use. We aimed to identify the profiles of e‐cigarette users from a regional community in Australia and investigate the associations of e‐cigarettes with respiratory symptoms and lung function. Methods A total of 519 participants completed a cross‐sectional study. Exposure to e‐cigarettes was collected via a validated questionnaire. Respiratory symptoms were evaluated via a self‐reported questionnaire and lung function measured with spirometry and forced oscillation technique (FOT). Linear and logistic regression models were fitted to investigate the associations between e‐cigarettes and outcomes, while controlling for confounders such as tobacco smoking. Results Of the 519 participants, 46 (9%) reported e‐cigarette use. Users tended to be younger (mean ± SD 45.2 ± 14.5 vs. 55.3 ± 16.0 years in non‐users), concurrently using tobacco products (63% vs. 12% in non‐users), have a mental health diagnosis (67% vs. 37% in non‐users) and have self‐reported asthma (63% vs. 42% in non‐users). After controlling for known confounders, chest tightness (OR = 2.4, 95% CI 1.2–4.9, p  = 0.02) was associated with e‐cigarette use. Spirometry was not different after adjustment for confounding. However, FOT showed more negative reactance and a greater area under the reactance curve in e‐cigarette users than non‐users. Conclusion E‐cigarette use was associated with increased asthma symptoms and abnormal lung mechanics in our sample, supporting a potential health risk posed by these products. Vulnerable populations such as young adults and those with mental health conditions have higher usage, while there is high concurrent tobacco smoking.